1. Technical Field
The present disclosure relates to a multi-functional surgical device for use with open or endoscopic surgical procedures including a multi-functional end effector. More particularly, the present disclosure relates to an electrosurgical device with a cutting device formed in the multi-functional end effector.
2. Description of Related Art
A variety of electrosurgical devices are commonly used in open and endoscopic surgical procedures. One device commonly used in both open and endoscopic procedures is a hemostat or forceps. A hemostat or forceps is a simple plier-like tool which uses mechanical action between its jaws to constrict vessels and is commonly used in open surgical procedures to grasp, dissect and/or clamp tissue. Electrosurgical forceps utilize both mechanical clamping action and electrical energy to effect hemostasis by heating the tissue and blood vessels to coagulate, cauterize and/or seal tissue.
By utilizing an electrosurgical forceps, a surgeon can either cauterize, coagulate/desiccate, reduce or slow bleeding and/or seal vessels by controlling the intensity, frequency and duration of the electrosurgical energy applied to the tissue. Generally, the electrical configuration of electrosurgical forceps can be categorized in two classifications: 1) monopolar electrosurgical forceps; and 2) bipolar electrosurgical forceps.
Monopolar forceps utilize one active electrode associated with the clamping multi-functional end effector and a remote patient return electrode or pad which is typically attached externally to the patient. When the electrosurgical energy is applied, the energy travels from the active electrode, to the surgical site, through the patient and to the return electrode.
Bipolar electrosurgical forceps utilize two generally opposing electrodes that are disposed on the inner opposing surfaces of the multi-functional end effectors and which are both electrically coupled to an electrosurgical generator. Each electrode is charged to a different electric potential. Since tissue is a conductor of electrical energy, when the effectors are utilized to grasp tissue therebetween, the electrical energy can be selectively transferred through the tissue.
In order to effect proper hemostatic fusion of vessels or tissue, two predominant mechanical parameters should be accurately controlled: the pressure applied to the vessels or tissue; and the minimum distance, the gap, between the jaws. As can be appreciated, both of these parameters may be affected by the thickness of the vessels or tissue being treated. Experience in vessel sealing, for example, has shown that accurate control of pressure is important for achieving reliable formation of hemostatic seals. Too little pressure results in poor adhesion giving seals that are likely to open or leak. Too much pressure damages or displaces tissue structures essential for the formation of strong seals. Accurate control of electrode gap is important to prevent short circuit conditions and to ensure that thin tissue structures can be fused. Electrode gaps of between about 0.001 inches to about 0.006 inches have proven to be effective on a variety of tissue conditions; however, it may be beneficial to adjust this range for specific situations.
With respect to smaller vessels, the pressure applied to the tissue tends to become less relevant whereas the gap distance between the electrically conductive surfaces becomes more significant for effective sealing. In other words, the chances of the two electrically conductive surfaces touching during activation increases as the vessels become smaller.
Electrosurgical methods may be able to seal larger vessels using an appropriate electrosurgical power curve, coupled with an instrument capable of applying a large closure force to the vessel walls. It is thought that the process of coagulating small vessels is fundamentally different than electrosurgical vessel sealing. For the purposes herein, “coagulation” is defined as a process of desiccating tissue wherein the tissue cells are ruptured and dried and vessel sealing is defined as the process of liquefying the collagen in the tissue so that it reforms into a fused mass. Thus, coagulation of small vessels is sufficient to permanently close them. Larger vessels need to be sealed to assure permanent closure.
The present disclosure provides a multi-functional surgical arrangement that may be incorporated into an open surgical device, an endoscopic surgical device or any other suitable surgical instrument. The multi-functional surgical arrangement includes a first device and second device, wherein the first device provides the primary function of the device and a second device provides one or more secondary functions of the device, such as, a cutting feature. The first device and the second device, in addition to providing primary and secondary functions, may together provide additional functionality separate from the primary and secondary functions provided by the first and second devices.